Case oneI was asked to take a history from an elderly woman. She had an of
acute angle-closure glaucoma in her left eye.
Slit-lamp examination revealed bilateral peripheral iridectomies and
trabeculectomies. She also had bilateral pseudophakia. Questions on the
management of acute angle closure glaucoma.

Case twoExamination of the fundi with 90D lens. The patient had a right disciform
scar in the right macula and in the left macula there was pigment epithelium
detachment. Questions on investigation including the advantages of ICG
over FFA and possible treatment modalities including PDT (photodynamic
therapy).

Case threeThe next patient was a woman in her 50s. Her right eye was dilated
and the examiner asked me to examine the macula with a direct ophthalmoscope.
The fundus showed myopic disc with Foster-Fuch's spots. Then, I was asked
to examine the left eye with a slit-lamp. She had had a left LASIK procedure.

Case fourThe last patient was a 65 year-old woman with a right esotropia. She
wore glasses for her high hypermetropia. Cover/uncover tests revealed esotropia
for near and distance with and without glasses. The bell went before I
had time to complete her ocular motility.

Medical Ophthalmology

Case oneThe first patient was a tall (more than 6') young woman and I immediately
suspected this to be a Marfan's syndrome. Sure enough her anterior segment
examination revealed bilateral contact lens wear for aphakia in both eyes.
I was asked to look for other signs of Marfan's syndrome in her. She
had arachnodactyly, high arch palate, arm span longer than height. I also
mentioned that I would like to carry out a cardiovascular examination.
The examiner asked me what medication would I give to Marfan's patient
with cardiovascular problems (the answer was beta blocker).

Case twoThis was visual field examination using confrontation method. I wanted
to start the test by presenting finger(s) in different quadrants but the
examiner stopped me and asked me to test the field with a white pin. There
was bitemporal superior quadrinopia.
I was asked about the systemic manifestation of pituitary problems
ie. galactorrhea, loss of hair and libido in men and infertility in women.

Case threeThe patient had bilateral prominent eyes suggestive of thyroid eye
disease. The examiners wanted me to examine the patient as if she was first
seen in the consultation clinic. There were especially interested to know
how I would test the optic nerve function (afferent pupillary defect, visual
field, colour vision and direct visualization of the disc), the type of
thyroid function tests and antibodies I would order. There was also a brief
discussion of differential diagnosis of proptosis.

Case fourI was asked to examine the fundi of a patient with an instrument of
my choice. I opted for slit-lamp using the 90D. In the right eye, there
was extensive pan-photocoagulation with new vessels elsewhere. Some of
the scars were white suggesting recent fill-in laser. The left fundus cannot
be visualized due to vitreous haemorrhage. The examiners asked me for the
differential diagnosis of vitreous haemorrhage (posterior vitreous detachment,
trauma, macroaneurysm, new vessels from retinal occlusive diseases)